Krista Moore, RN

Key facts

NPI

1255869459

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

805599 (CA)

Practice address

38883 Hwy 299
Willow Creek, CA 95573-0726

Phone

(530) 629-3111

NPI assigned

Jun 1, 2017

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 1, 2017.

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496275200000",
    "number": "1255869459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST STE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216249",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38883 HWY 299",
            "city": "WILLOW CREEK",
            "state": "CA",
            "postal_code": "955730726",
            "telephone_number": "530-629-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KRISTA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2017-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "805599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Judi G Nelson, P.T.
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• Thomas Weisend, RN

All providers in Willow Creek, CA · Registered Nurse in California